Car Safety Seats

The #1 killer and crippler of children in the United States
is motor vehicle crashes. More than 600 children under the
age of 5 years are killed each year, and about 270,000 are
injured. Proper use of car safety seats can reduce traffic
fatalities by at least 80%. All 50 states have passed laws
that require children to ride in approved child passenger
safety seats.

A parent cannot protect a child by holding him or her
tightly. In a 30-mile-per-hour crash, the child will either
be crushed between the parent's body and the dashboard or
ripped from the parent's arms and possibly thrown from the
car. Car safety seats also help to control a child's
misbehavior, prevent motion sickness, and reduce the number
of accidents caused by a child distracting the driver.

What are the types of car safety seats?

Before you buy a car safety seat, look at several different
models. Make sure that the car seat will fit in your car
and that your seat belts will work with the seat. There are
several types of car safety seats:

Infant-only seats: These are rear-facing only seats.
They can be used from birth until a child weighs
approximately 20 pounds (depending on the model). They
are small and portable.

Some of these seats come with a detachable base. You
attach the base to the seat of the car. This allows you
to easily snap the car seat in and out of the car without
reinstalling the car seat each time. If the base does
not attach tightly to your car, it is better to attach
the seat each time and not use the base.

Convertible safety seats: These seats can be used in
both rear- and forward-facing positions. The seat needs
to stay in the rear-facing position until your child is
over 1 year old and has reached the highest weight
allowed for the rear-facing position (usually about 30
pounds, but may be more or less depending on the car
seat). They can then be used in the forward-facing
position until the child has reached 40 pounds.

Combination seats: These seats are forward-facing seats
that can be used after your child has reached 20 pounds
and is at least 1 year old. Your child must wear the
5-point harness until he or she has reached 40 pounds.
When you child is over 40 pounds, you can use this seat
as a booster seat by correctly positioning the car's
lap/shoulder belt across your child. It can be used as a
booster seat until your child is about 80 pounds
(depending on the model).

Booster seats: These are forward-facing seats that lift
the child higher so your car's lap/shoulder belt will fit
correctly over the child. A booster seat is for children
over 40 pounds. It should be used until the child is 56
inches tall, a height usually reached between 9 and 12 years
of age.

Travel vests: Travel vests are used if you only have lap
belts in your car. They vary in weight ranges depending
on the model, but are typically used for children at
least 2 years old and up to 100 pounds. The lap belt
fits through a backrest or loops and the shoulder straps
come over your child and buckle.

Built-in seats (integrated seats): Some cars and vans
come with built-in child safety seats. These may be used
by children who are over 1 year of age and weigh at least
20 pounds. Weight and height requirements vary depending
on the car manufacturer. Check with the maker of the car
to find out the specific height and weight requirements.

What is LATCH?

Starting in 2002, most new vehicles and car safety seats will
have a new system called LATCH (Lower Anchors and Tethers
for Children). This system may be an easier way to attach
safety seats. It allows you to attach the car seat without
using a seat belt. However, you will need to continue
attaching the car safety seat with a seat belt unless you
have both a new car seat and a new car with the LATCH
system.

What are tethers?

Tether straps are found on most new forward-facing car
seats. A tether strap hooks the top of a car safety seat to
a permanent anchor in the car to provide extra protection.
Tethers reduce the amount of forward movement of the car
seat in a crash. Check your car to see if it has an anchor.
Cars made since September 2000 are required to have tether
anchors. Cars made since 1989 can be retro-fitted with
tether straps. Most anchors are on the rear window ledge,
back of the seat, floor, or ceiling of the car. There are
tether kits available for older car seats. Check with your
car seat and car manufacturer.

Where should the car seat be placed?

Whenever possible and at any age, put the safety seat in the
back seat of the car, which is much safer than the front
seat.

Air bags are standard equipment in most new cars. They have
saved many lives. However, they are very hazardous to
infants in REAR-facing child safety seats and have caused
death from brain injury. If your car has air bags, take the
following precautions:

Infants riding in REAR-facing child safety seats should
NEVER be placed in the front seat of a car or truck with
a passenger-side air bag. They must be in the car's rear
seat or not ride in that vehicle.

Children in FORWARD-facing child safety seats should also
ride in a car's rear seat until 12 years of age.

If the vehicle does not have a rear seat, children riding
in the front seat should be positioned as far back as
possible from the air bag. Move the seat all the way
back so that the child is as far as possible from the
dashboard. Some cars come with air bag ON/OFF switches.
Turn the air bag off only if your car has no back seat.

When can my child use a regular seat belt?

Keep your child in a booster seat as long as possible. Your
child could be ready for a regular seat belt anywhere
between 9 and 12 years old depending on height and weight.
Your child should be about 4' 9" tall and at least 60 to 80
pounds to properly fit an adult seat belt. When your child
is ready for a regular seat belt, use a lap belt low across
the thighs. If your child is using a shoulder belt, it
should cross your child's chest, not the neck or throat.
Never put the shoulder belt under both arms or behind the
back.

What are the safety standards?

Since January 1981, all manufacturers of child safety seats
have been required to meet stringent federal government
safety standards, including crash-testing. The American
Academy of Pediatrics (AAP) publishes a list of infant/child
safety seats that have met the Federal Motor Vehicle
Standards. The list is updated yearly. To get this list,
write to the AAP or visit their Web site:

Each state has its own seat belt laws and safety standards.
Although all states require that children are buckled in,
not all states require that children travel in the safest
way possible. Using a car safety seat correctly is very
important. Follow the safety seat instructions and make
sure you are keeping your child as safe as possible.

Tips for Using a Car Seat Properly

If used consistently and properly, your child's car seat can
be a lifesaver. Your attitude toward safety belts and car
seats is especially important. If you treat buckling up as
a necessary, automatic routine, your child will follow your
lead and also accept car seats and seat belts. To keep your
child safe and happy, follow these guidelines:

Always use the safety seat. Use the safety seat on the
first ride home from the hospital, and continue using it
for every ride.

Everyone buckles up. Allow NO exceptions for older kids
and adults. If adults ride unprotected, the child
quickly decides that safety is just kid stuff.

Give frequent praise for appropriate behavior in the car.

Remember that a bored child can become disruptive. Keep
a supply of favorite soft toys on hand. Use food as a
last resort, because they contribute to the unhealthy
habit of snacking and overeating.

NEVER let a fussy child out of the car seat or safety
belt while the car is in motion. If your child needs a
break, STOP the car. Responding to complaints by
allowing your child to ride unprotected is a disastrous
decision that will make it harder to keep him or her in
the seat on the next ride.

Parents should never take off their seat belt to reach into
the back seat to attend to a child while the car is in
motion. Too many parents have been seriously injured when
their car was struck during those few seconds.

Some infants begin crying at 4 or 5 months (possibly from
separation anxiety) when placed in their rear-facing car
seats. Try distracting them with music and toys. Also
give them practice time in the car seat at home. Use it
for pleasant activities such as playing and eating.

If a child tries to get out of the seat, stop the car and
firmly but calmly explain that you won't start the car
until he or she is again buckled in the car seat.

Booster seats must be used with a lap/shoulder belt.

When your child travels in another person's car (such as
a baby sitter's or grandparent's car), insist that the
driver also use the safety seat.

For long-distance trips, plan for frequent stops and try
to stop before your child becomes restless. Cuddle a
young child. Let an older child snack and run around for
10 to 15 minutes.

(Originally adapted from the American Academy of Pediatrics
with permission)

This content is reviewed periodically and is subject to
change as new health information becomes available. The
information is intended to inform and educate and is not a
replacement for medical evaluation, advice, diagnosis or
treatment by a healthcare professional.